Billing

DMEPOS Prior Authorization

Medicare’s New DMEPOS Prior Authorization Requirement

December 31, 2015
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As of the beginning of 2016, CMS is starting a prior authorization process for certain DMEPOS. If you have not already heard of this new authorization requirement, you are likely to hear quite a bit about it in the next month or two.

The good news […]

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icd-10 7th character

When to Use ICD-10 7th Character

October 10, 2015
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We are understandably receiving a lot of questions regarding how and when to use the ICD-10 7th character.

The ICD-10 7th character is only required when the ICD-10 rules specifically ask for the 7th character and give you a choice as to which […]

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medicare cap

Therapy Manual Medical Review Changes for 2015

September 19, 2015
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As we get closer to the end of 2015, more of you may be treating Medicare patients who are at or above the $3,700 cap for manual medical review.

Last year, every PT or OT claim above $3,700 was subject to manual medical review […]

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palmetto processing error

Palmetto Processing Error Causes 97140 Denials

July 11, 2015
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Palmetto Processing Error 97140 Denials to be resolved automatically.

Therapy providers whose Medicare claims are processed by Palmetto may
see some strange denials of 97140 from June 18-July 5, 2015 with explanation code 50 for lack of medical necessity. These denials were due to a […]

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